Organization
LIFE MANAGEMENT RESOURCES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARYJANE BLANCHFIELD LICSW (CEO)
(701) 665-5433
Entity
Organization
Contact information
Practice address
400 12TH AVE NE, DEVILS LAKE, ND 58301-2712
(701) 665-5433
Mailing address
400 12TH AVE NE, DEVILS LAKE, ND 58301-2712
(701) 665-5433
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
603
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
19193
—
ND
Enumeration date
07/03/2008
Last updated
07/03/2008
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